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The incidence of osteoporotic vertebral compression fractures (OVCF) is increasing year by year. OVCF is manifested by thoracolumbar back pain, kyphosis and limitation of motion, which severely reduces the quality of life and life expectancy of the patients. It is often caused by minor violence with an insidious onset, and has a high rate of missed diagnoses on routine examination. Currently, percutaneous vertebroplasty (PVP) and percutaneous kyphoplasty (PKP) are effective treatments for OVCF, but postoperative complications such as cement leakage and vertebral re-fracture occur often. Digital orthopedic technology is an emerging interdisciplinary discipline that combines computer digital technology with orthopedic clinics. As a new orthopedic clinical technology, digital orthopedic technology is pushing the boundaries of spinal surgery research and clinical application due to its advantages in individualization, precision, and minimally invasiveness, and is currently at a rapid development stage with high endurance and high throughput. To this end, the authors outlined the current application of digital orthopedic technology in OVCF, so as to provide a reference for achieving rapid and accurate diagnosis of OVCF and formulating reasonable treatment plans.
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Objective:To purify H5N1 influenza virus concentrate prepared by MDCK cells with a new mixed-mode chromatography medium Capto Core700 and the traditional medium Sepharose 4FF, and to compare the separation and purification efficacy of the two media.Methods:Capto Core700 and Sepharose 4FF were used to purify inactivated H5N1 influenza virus concentrate. The morphology of virus particles in different samples was then observed under a transmission electron microscope. Single radial immunodiffusion (SRID), Folin-Phenol (Lowry) method, double-antibody sandwich ELISA and qPCR were used to detect hemagglutinin, total protein, host cell protein (HCP) and host cell DNA (HCD) before and after purification. The recovery rate of virus antigen and the removal rate of impurities were calculated. The immunogenicity of the viruses purified with different media was analyzed using animal experiments. Difference in the purification efficacy of the two chromatography media was analyzed by t-test. Results:H5N1 influenza viruses purified by Capto Core700 or Sepharose 4FF showed the typical influenza virus morphology under transmission electron microscope. There was no significant difference in the recovery rate of hemagglutinin between the two chromatography media ( P>0.05), but compared with Sepharose 4FF, Capto Core700 had a higher removal rate of impurities (total protein, HCP, HCD) and the difference was statistically significant ( P<0.05). Animal experiments showed that the viruses purified by the two chromatography media had good immunogenicity. Conclusions:Compared with Sepharose 4FF chromatography medium, Capto Core700 could more effectively remove process-related impurities such as HCP, HCD and total protein without affecting the recovery rate of viral antigen. This study provided reference for the development of purification technology in the production of H5N1 influenza virus vaccine in MDCK cells.
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Re-fracture of the injured vertebrae is a serious complication after vertebral augmentation for osteoporotic thoracolumbar fractures (OTLF), manifested by recurrent lower back pain, limitation of spinal motion and increased retroflexion deformity. The clinical treatment of re-fracture of the injured vertebrae is difficult, and some patients even need spinal function reconstruction to stabilize the fractured vertebrae, which has a serious impact on their postoperative rehabilitation, quality of life and economic burdens. Re-fracture of the injured vertebrae after vertebral augmentation for OTLF is closely related to patient factors, bone cement factors and perioperative factors. To this end, the authors discuss the risk factors for re-fracture of the injured vertebrae after vertebral augmentation for OTLF and propose corresponding management methods to provide a reference for understanding the risk of re-fracture of the injured vertebrae and improving the clinical treatment.
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Objective:To compare the clinical effects between cannulated screwing and plating in combination with interlocking intramedullary nailing for the treatment of ipsilateral discontinuous fractures of the tibial shaft and plateau.Methods:A retrospective analysis was performed of the clinical data of 34 patients who had been treated for ipsilateral discontinuous fractures of the tibial shaft and plateau at Department of Orthopedics and Trauma, Honghui Hospital Affiliated to Xi′an Jiaotong University from January 2015 to January 2020. There were 17 males and 17 females, aged from 26 to 60 years (average, of 43.6 years). The left side was affected in 18 cases and the right side in 16. The patients were divided into 2 groups according to their internal fixation methods: a cannulated screw group of 16 cases treated with cannulated screwing and intramedullary nailing and a plate group of 18 cases treated with plating and intramedullary nailing. The 2 groups were compared in terms of operation time, intraoperative blood loss, incision length, tibial plateau collapse, consumables cost, hospital stay, fracture healing time, weight-bearing time, range of knee motion, reduction of tibial plateau fracture by Rasmussen radiology, Lysholm knee function score at the last follow-up and complications.Results:There was no significant difference in the preoperative general data between the 2 groups, showing the 2 groups were comparable ( P>0.05). All the 34 patients were followed up for 12 to 28 months (average, 17.4 months). There was no significant difference either in operation time, hospital stay, tibial plateau healing time, tibial fracture healing time, weight-bearing time or range of knee motion between the 2 groups ( P>0.05). In the cannulated screw group, the intraoperative blood loss [(89.4 ± 14.5) mL] and consumables cost [(2.0 ± 0.2) ten thousand yuan] were significantly less than those in the plate group [(120.8 ± 22.1) mL and (2.6 ± 0.4) ten thousand yuan], the incision length [(4.1 ± 0.8) cm] was significantly shorter than that in the plate group [(7.1 ± 0.9) cm], and the Lysholm knee function score at the last follow-up [(89.8 ± 4.5) points] was significantly lower than that in the plate group [(93.0 ± 4.2 points] (all P<0.05). The difference was statistically significant between the 2 groups in the quality of tibial plateau reduction ( P<0.05). The postoperative tibial plateau collapse in the plate group [0.5 (0, 2) mm] was insignificantly less than that in the cannulated screw group [1.0 (0, 2) mm] ( P>0.05). In the cannulated screw group, one tibial shaft fracture did not achieve union after operation and deep vein thrombosis occurred in 2 cases after operation; in the plate group, 2 cases suffered from delayed wound healing, one from delayed fracture healing, one from deep venous thrombosis of lower extremity, and one from knee discomfort which was relieved after removal of internal fixation. Conclusions:In the treatment of ipsilateral discontinuous fractures of tibial shaft and plateau, both cannulated screwing and plating in combination with interlocking intramedullary nailing can achieve good clinical effects. Although plating in combination with intramedullary nailing lead to more severe trauma and higher costs, it is conducive to improving the reduction quality of the tibial plateau and postoperative functional recovery of the knee joint.
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Objective:To compare the clinical efficacy of femoral neck system (FNS) and cannulated screw fixation in the treatment of femoral neck fracture in the young and middle-aged patients.Methods:A retrospective cohort study was conducted to analyze the clinical data of 76 young and middle-aged patients with femoral neck fracture admitted to Honghui Hospital Affiliated to Xi′an Jiaotong University from March 2018 to September 2020, including 45 males and 31 females, aged 23-63 years [(49.5±8.2)years]. Garden classification of the fracture was 25 patients with type II, 34 with type III and 17 with type IV. Pauwels classification of the fracture was 16 patients with type I, 31 with type II and 29 with type III. A total of 40 patients were treated with cannulated screw fixation (cannulated screw group) and 36 patients with FNS fixation (FNS group). Operation time, frequency of fluoroscopy, length of hospital stay, weight-bearing time and bone union time were compared between the two groups. Hip function was assessed by Harris hip score at 6, 12 months after operation. The incidence of postoperative complications was observed.Results:All patients were followed up for 12-20 months [(15.2±1.7)months]. The frequency of fluoroscopy [(13.4±1.9)times], weight-bearing time [(11.1±1.9)weeks] and bone union time [(13.8±1.6)weeks] in FNS group were lower or shorter than those in cannulated screw group [(18.2±2.6)times, (15.7±1.6)weeks, (14.6±1.6)weeks] (all P<0.05 or 0.01). There were no significant differences in operation time, length of hospital stay and Harris hip score at 6, 12 months after operation between the two groups (all P>0.05). No postoperative infection occurred in both groups. In cannulated screw group, there were 4 patients with femoral neck shortening, 3 with deep venous thrombosis, 2 with internal fixation loosening, 2 with nail withdrawal and 1 with fracture non-union, showing the incidence of complications of 30% (12/40). In FNS group, there was 2 patients with femoral neck shortening, 1 with deep vein thrombosis and 1 with internal fixation loosening, showing the incidence of complications of 11% (4/36) ( P<0.05). Conclusion:For femoral neck fracture in the young and middle-aged patients, both FNS and cannulated screw fixation can obtain satisfactory efficacy, but FNS has the advantages of decreased frequency of intraoperative fluoroscopy, early weight bearing, reduced time to bone union and low incidence of complications.
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With the large use of vertebral augmentation in the treatment of osteoporotic thoracolumbar fracture (OTLF), the complication of cement leakage has become an increasing concern. Although most cement leakage has no obvious clinical symptoms, some patients still sustain serious complications such as vertebral fracture, pulmonary embolism and spinal nerve compression. Cement leakage is closely related to patients′ own factors, cement factors and perioperative related factors. To clarify the risk factors of cement leakage with implementation of preventive measures accordingly is of great guiding significance to improve the clinical efficacy and surgical safety. Therefore, the authors discuss bone cement leakage in aspects of the risk factors and preventive measures so as to provide a reference for reducing the incidence of cement leakage.
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Objective:To investigate the risk factors associated with the occurrence of proximal junctional kyphosis (PJK) after posterior long-segment internal fixation for type IV chronic symptomatic osteoporotic thoracolumbar fracture (CSOTLF) in the elderly.Methods:A case-control study was used to analyze the clinical data of 95 elderly patients with type IV CSOTLF treated in Honghui Hospital affiliated to Xi′an Jiaotong University from January 2013 to June 2018, including 32 males and 63 females, aged from 60 to 85 years［(67.4±6.5) years］. Injured segments were T 11 in 17 patients, T 12 in 37, L 1 in 30 and L 2 in 11. All patients were treated with posterior long-segment internal fixation and divided into PJK group ( n=30) and non-PJK group ( n=65) according to whether PJK occurred after surgery. Univariate analysis was performed for the correlation of the following indices with the incidence of postoperative PJK, including general information such as gender, age, body mass index (BMI), bone mineral density (BMD), history of smoking, cause of injury, comorbidities, injury segments, American Spinal Injury Association (ASIA) classification and time from injury to surgery, preoperative imaging data such as posterior junctional angle (PJA), sagittal vertical axis (SVA), pelvic incidence-lumbar lordosis difference (PI-LL), pelvic tilt (PT) and sacral slope (SS), basic surgical data such as posterior ligament complex (PLC) injury, location of upper instrumented vertebrae (UIV), location of lower instrumented vertebrae (LIV) and number of fixed segments. Multifactorial Logistic regression analysis was used to measure the independent risk factors associated with the occurrence of postoperative PJK. Results:Univariate analysis showed that the incidence of postoperative PJK was correlated with age, BMI, BMD, preoperative PJA, preoperative SVA, preoperative PI-LL, PLC injury, location of UIV, location of LIV and number of fixed segments (all P<0.05), rather than gender, history of smoking, cause of injury, comorbidities, injury segments, ASIA classification, time from injury to surgery, preoperative PT and preoperative SS (all P>0.05). Multifactorial Logistic regression analysis showed that age ≥70 years ( OR=32.28, 95% CI 3.83-272.29, P<0.01), BMI>28.0 kg/m 2 ( OR=7.88, 95% CI 1.63-37.99, P<0.01), BMD T value<-3.5 SD ( OR=20.84, 95% CI 2.36-183.93, P<0.01), preoperative PI-LL>20° ( OR=13.30, 95% CI 1.54-113.87, P<0.05) and PLC injury ( OR=13.98, 95% CI 1.37-142.34, P<0.05) were significantly associated with the occurrence of postoperative PJK. Conclusions:Age≥70 years, BMI>28 kg/m 2, BMD T value<-3.5 SD, preoperative PI-LL>20° and PLC injury are independent risk factors for the incidence of PJK after posterior long-segment internal fixation in elderly patients with type IV CSOTLF. Attention should be paid to soft tissue protection and sagittal balance restoration of the spine intraoperatively and weight control and anti-osteoporosis treatment postoperatively.
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Objective:To explore the clinical effects of unilateral secondary puncture percutaneous vertebroplasty (PVP) in the treatment of type ⅡA acute symptomatic osteoporotic thoracolumbar fractures (ASOTLF).Methods:A retrospective case-control study was conducted to analyze the clinical data of 193 patients with type ⅡA ASOTLF who had been admitted to Department of Spine Surgery, Honghui Hospital from February 2016 to October 2018. They were 71 males and 122 females, aged from 65 to 90 years [average, (73.9±4.3) years]. The segments injured were T10 in 21 cases, T11 in 27 cases, T12 in 44 cases, L1 in 48 cases, L2 in 29 cases, L3 in 14 cases, and L4 in 10 cases. Of them, 85 received unilateral secondary puncture PVP (observation group) and 108 did not (control group). The clinical effects were evaluated by comparing between the 2 groups the operation time, bone cement injection volume, intraoperative blood loss, hospital stay, and visual analogue scale (VAS) for back pain, spinal Oswestry disability index (ODI), anterior height of the injured vertebral body (AH) and kyphosis angle (KA) of the injured vertebra before operation, at 3 days after operation and the last follow-up. The bone cement leakage and fracture of adjacent vertebral body were observed.Results:All patients were followed up for 12 to 24 months (average, 15.8 months). There was no significant difference in the preoperative general data between the 2 groups, showing they were comparable ( P>0.05). The operation time and bone cement injection volume [(36.2±1.4) min and (5.5±0.7) mL] in the observation group were significantly longer or more than those in the control group [(32.3±1.7) min and (4.0±0.7) mL] ( P<0.05). There was no significant difference in the hospital stay or intraoperative blood loss between the 2 groups ( P>0.05). The VAS, ODI, AH and KA at 3 days after operation and the last follow-up were significantly improved compared with those before operation in both groups ( P<0.05). There was no significant difference in VAS, ODI, AH or KA between the 2 groups before operation or at 3 days after operation ( P>0.05). However, the VAS, ODI, AH and KA at the last follow-up in the observation group [(2.2±0.8) points, 19.2%±5.8%, (2.90±0.21) cm, and 12.2°±1.5°] were better than those in the control group [(3.1±0.9) points, 22.8%±5.3%, (2.41±0.15) cm, and 13.3°±1.2°]. There was no significant difference between the 2 groups in the incidence of postoperative bone cement leakage or that of adjacent vertebral fracture ( P>0.05). Conclusions:In the treatment of type ⅡA ASOTLF, unilateral secondary puncture PVP can result in satisfactory clinical effects, because it effectively promotes dispersion of bone cement and prevents re-collapse of the vertebra operated but does not increase the risks of bone cement leakage and adjacent vertebral fracture.
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Spinal tuberculosis is one of the common causes of severe kyphosis. The formation of spinal tuberculosis kyphosis is multi-factors, including age at the time of infection, the cumulative number of segments, the height of vertebral body loss before treatment, and "spine danger signs" . Although the use of anti-tuberculosis drugs has achieved good results, for patients with spinal tuberculosis cured by drug treatment, the kyphosis will continue to progress and gradually develop into a severe kyphosis. Then there are a series of problems such as appearance, psychology, rib-pelvic impingement, cardiopulmonary dysfunction, and nerve and spinal cord compression. The X-ray signs of the height of the vertebral body loss and "spine danger signs" before treatment can help predict the severity of future deformities. Therefore, a comprehensive understanding of the formation of kyphosis of spinal tuberculosis and individualized selection of surgical methods according to the specific conditions of the disease as soon as possible can effectively prevent the formation of kyphosis and reduce the incidence of neurological damage and delayed paralysis.
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Objective:To compare the clinical efficacy of percutaneous vertebroplasty (PVP) and non-surgical treatment of patients with type I fracture according to the acute symptomatic osteoporotic thoracolumbar fracture (ASOTLF) classification.Methods:A retrospective case-control study was used to analyze the clinical data of 115 patients with ASOTLF admitted to Honghui Hospital of Xi'an Jiaotong University from January 2015 to December 2018. There were 48 males and 67 females, aged 65-92 years [(75.3±8.5)years]. According to clinical symptoms and imaging characteristics, all patients were identified with type I fracture according to the ASOTLF classification. Injury segments were at T 6 to T 10 in 10 patients, at T 11 in 15, at T 12 in 26, at L 1 in 34, ay L 2 in 18, at L 3 in 7, and at L 4 in 5. A total of 73 patients received PVP combined with anti-osteoporosis treatment (surgery group), and 42 patients received non-surgery combined anti-osteoporosis treatment (non-surgery group). Before treatment, at 1 day, 1 month, 3 months, 6 months after treatment, and at the last follow-up, the visual analogue scale (VAS) was used to assess the pain, the Roland Morris Disability (RMD) score to assess the spinal function, and the Quality of Life Questionnaire of the European Foundation for Osteoporosis (QUALEFFO) score to evaluate the quality of life. The bone mineral density was compared between groups before treatment and at 1 year after treatment. The complications were observed as well. Results:All patients were followed up for 12-18 months [(13.2±4.6)months]. At 1 day, 1 month, and 3 months after treatment, the VAS in surgery group [(3.9±0.6)points, (3.3±0.6)points, (2.9±0.3)points] was significantly lower than that in non-surgery group [(6.0±0.7)points, (5.0±0.8)points, (4.2±1.0)points, respectively] (all P<0.05); the RMD score in surgery group [(15.2±0.7)points, (12.6±0.7)points, (10.6±0.7)points] was significantly lower than that in non-surgery group [(16.4±0.8)points, (14.6±0.8)points, (12.7±0.6)points, respectively] (all P<0.05). At 1 day and 1 month after treatment, the QUALEFFO score in surgery group [(46.0±1.1)points, (41.4±0.8)points] was lower than that in non-surgery group [(50.3±0.8)points, (44.7±1.2)points] (all P<0.05). There was no statistically significant difference between the two groups at other time points of the above indicators ( P>0.05). At 1 year after treatment, the bone mineral density in surgery group was (-3.0±0.9)SD, and was (-2.8±1.1)SD in non-surgery group ( P>0.05). There was no significant difference in the incidence of complications between surgery group [37%(27/73)] and non-surgery group [33%(14/42)] ( P>0.05). Conclusion:For patients with ASOTLF type I fracture, PVP and non-surgical treatment has similar effects in anti-osteoporosis and occurrence of complications, but the PVP is superior to non-surgical treatment in early pain relief, spinal function improvement and quality of life.
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Objective:To explore the clinical effect of percutaneous vertebroplasty (PVP) at stage I in treatment of acute multi-segment osteoporotic vertebral compression fracture (OVCF) in the elderly with over 3 vertebrae operated.Methods:A retrospective case-control study was conducted to analyze the clinical data of 105 aged patients with acute multi-segment OVCF admitted to Honghui Hospital, Xi'an Jiaotong University from October 2015 to February 2019. There were 27 males and 78 females, aged 65-92 years [(73.0±14.5)years]. All patients received stage I multi-segmental PVP and standard anti-osteoporosis treatment. There were more than 3 operative vertebral segments in 30 patients (observation group) and less than or equal to 3 operative vertebral segments in 75 patients (control group). The operation time, intraoperative fluoroscopy frequency, cement injection volume, cement leakage rate and incidence of recurrent vertebral fractures were compared between the two groups. The visual analogue scale (VAS), Oswestry disability index (ODI) and activity of daily living (ADL) score were compared before operation, 1 day, 1 month after operation and at the last follow-up.Results:All patients were followed up for 11-13 months [(12.5±1.8)months]. The observation group showed operation time of (71.2±12.2)minutes, intraoperative fluoroscopy frequency of (38.8±6.4)times and cement injection volume of (20.2±4.6)ml, more than those in control group [(52.3±10.6)minutes, (25.4±5.3)times, (12.3±4.3)ml] ( P<0.05). There was no significant difference in cement leakage rate and incidence of recurrent vertebral fractures between the two groups ( P>0.05). No complications such as infection, nerve damage or cement implantation syndrome occurred. Before operation, 1 day after operation, 1 month after operation and at the last follow-up, the VAS in observation group [(7.6±0.7)points, (3.0±0.8)points, (2.3±0.7)points, (2.2±0.6)points] showed no significant difference from those in control group [(7.4±0.5)points, (2.9±0.4)points, (2.1±0.5)points, (2.0±0.5)points], the ODI in observation group [(74.6±3.3)%, (36.8±4.6)%, (29.7±4.0)%, (24.0±3.6)%] did not differ from those in control group [(73.8±1.0)%, (35.1±0.9)%, (28.4±2.2)%, (22.8±0.9)%], the ADL score in observation group [(34.5±5.0)points, (54.5±3.8)points, (73.7±3.9)points] were similar with those in control group [(36.2±3.4)points, (56.8±4.7)points, (75.3±5.3)points, (81.3±4.5)points] (all P>0.05). The postoperative VAS, ODI and ADL score in both groups were significantly improved in comparison with preoperation ( P<0.05). Conclusion:For acute multi-segment OVCF in the elderly with over 3 or not more than 3 the vertebrae operated, PVP at stage I has the same advantages in early pain relief and improvement of motor function and quality of life.
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Objective:To establish the acute symptomatic osteoporotic thoracolumbar fracture (ASOTLF) classification system, and to examine the reliability and evaluate the effect of clinical application.Methods:A retrospective case series study was conducted to analyze the clinical data of 1 293 patients with osteoporotic thoracolumbar fracture(OTLF) admitted to Honghui Hospital from January 2016 to December 2018. There were 514 males and 779 females, aged 57-90 years [(71.4±6.3)years]. The T value of bone mass density was -5.0--2.5 SD [(-3.1±-0.4)SD]. According to the clinical symptoms a and fracture morphology, OTLF was divided into 4 types, namely type I(I occult fracture), type II(compressed fracture), type III (burst fracture) and type IV(unstable fracture). The type II was subdivided into three subtypes (type IIA, IIB, IIC), and the Type III into two subtypes (type IIIA, IIIB). of all patients, 75 patients (5.8%) were with type I, 500 (38.7%) with type II A, 134 (10.4%) with type IIB, 97 (7.5%) with type IIC, 442 (34.2%) with type IIIA, 27(2.1%) with type IIIB and 18 (1.4%) with type IV. After testing the validity of the classification, different treatment methods were utilized according to the classification, including percutaneous vertebroplasty (PVP) for Type I, PVP after postural reduction for Type II, percutaneous kyphoplasty (PKP) for Type IIIA, posterior reduction and decompression, bone graft fusion and bone cement-augmented screw fixation for Type IIIB, and posterior reduction, bone graft fusion and bone cement-augmented screw fixation for Type IV. The visual analog score (VAS), Oswestry disability index (ODI), Frankel grade of spinal cord injury, local Cobb Angle, and vertebral body angle (vertebral body angle) were recorded in all patients and in each type of patients before surgery, at 1 month after surgery and at the last follow-up. The neurological function recovery and complications were also recorded.Results:The patients were followed up for 24-43 months [(29.9±5.1)months]. A total of 3 000 assessments in two rounds were conducted by three observers. The overall κ value of inter-observer credibility was 0.83, and the overall κ value of intra-observer credibility was 0.88. The VAS and ODI of all patients were (5.8±0.7)points and 72.5±6.6 before surgery, (1.8±0.6)points and 25.0±6.3 at 1 month after surgery, and (1.5±0.6)points and 19.5±6.2 at the last follow-up, respectively (all P<0.05). The Cobb angle and vertebral body angle of all patients were (13.0±9.1)° and (8.0±4.6)° before surgery, (7.9±5.2)° and (4.6±2.9)° at 1 month after surgery, and (9.1±6.0)° and (5.8±3.0)° at the last follow-up, respectively (all P<0.05). At the last follow-up, VAS, ODI, Cobb Angle and VBA of each type of patients were significantly improved compared with those before surgery (all P<0.05). The spinal cord compression symptoms were found 1 patient with type IV and 5 patients with type IIIB preoperatively. At the last follow-up, neurological function improved from grade C to grade E in 1 patient and from grade D to grade E in 5 patients ( P<0.05). The lower limb radiation pain or numbness in 3 patients with type IV and 22 patients with type III preoperatively were fully recovered after surgical treatment at the last follow-up except for three patients. Conclusions:The ASOTLF classification is established and has high consistency and reliability. The classification-oriented treatment strategy has achieved a relatively satisfactory effect, indicating that the classification has a certain guiding significance for treatment of OTLF.
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Objective:To explore the treatment options for patients with osteoporotic thoracolumbar injury classification and severity score (OTLICS) of 4 points following acute symptomatic osteoporotic vertebral compression fracture (OVCF) .Methods:A retrospective case-control study was conducted to analyze the clinical data of 108 patients with acute symptomatic OVCF admitted to Honghui Hospital, Xi'an Jiaotong University Faculty of Medicine from February 2016 to February 2018. There were 21 males and 87 females, aged 55-92 years [(71.6±5.3)years]. All patients had OTLICS score of 4 points. Of all, 76 patients were treated operatively (surgery group) and 32 patients were treated non-operatively (non-surgery group). The visual analogue scale (VAS), Oswestry disability index (ODI) and quality of life score (SF-36) were compared between the two groups before treatment, at 1 week, 3 months, 6 months after treatment, and at the last follow-up. The recovery of the injured vertebrae before and after treatment (Cobb angle of the injured vertebra, relative height of the anterior edge of the injured vertebrae), adjacent vertebral body fractures, and complications were compared between the two groups.Results:All patients were followed up for 12-18 months [(13.4±4.2)months]. At 1 week, 3 months and 6 months after treatment, the VAS in surgery group [(3.5±1.0)points, (2.1±0.6)points, (2.0±0.4)points] was better than that in non-surgery group [(6.4±1.7)points, (5.3±1.5)points, (3.3±0.6)points] ( P<0.05), the ODI in surgery group [(45.8±10.3)points, (35.3±8.6)points, (26.5±7.1)points] was better than that in non-surgery group [(65.7±12.1)points, (58.3±10.7)points, (45.6±9.3)points] ( P<0.05), the SF-36 in surgery group [(82.8±1.4)points, (85.0±1.5)points, (88.0±1.3)points] was better than that in non-surgery group [(80.4±1.3)points, (81.5±1.4)points, (85.6±1.1)points] ( P<0.05). At the last follow-up, there were no significant differences in VAS, ODI and SF-36 between the two groups ( P>0.05). At 3 months, 6 months and the last follow-up, the Cobb angle in surgery group [(18.3±3.9)°, (17.5±3.0)°, (17.8±1.6)°] was better than that in non-surgery group [(22.4±2.2)°, (22.5±1.7)°, (22.1±1.3)°] ( P<0.05), and the relative height of the anterior edge of the injured vertebra in surgery group [(75.4±8.6)%, (76.6±8.6)%, (75.2±8.3)%] was better than that in non-surgery group [(63.5±7.6)%, (65.2±7.4)%, (62.8±7.2)%] ( P<0.05). The adjacent vertebral fractures occurred in 6 patients (8%) in surgery group, and in 2 patients (6%)in non-surgey group ( P>0.05). Postoperative complications occurred in 8 patients (11%) in surgery group, and occurred in 6 patients (19%) in non-surgery group ( P>0.05). Conclusion:When applying the OTLICS scoring system to treat acute symptomatic OVCF, patients with OTLICS score of 4 points should be promptly treated with operatively, which can quick relieve pain, correct deformities promote functional recovery, and improve quality of life.